Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 272
Filtrar
1.
Ned Tijdschr Tandheelkd ; 125(4): 217-222, 2018 Apr.
Artigo em Holandês | MEDLINE | ID: mdl-29659639

RESUMO

Erosive tooth wear has recently been at the centre of attention and its prevalence of erosive tooth wear among adolescents in the Netherlands appears to be rising. The multifactorial nature of the aetiology of the condition makes it difficult to identify the relevant causal factors, both in individual cases and within the general population. Preventive intervention is indicated in those cases where (active) erosive tooth wear is diagnosed. Early diagnosis is important, especially in younger patients. Preventive measures, such as dietary advice and the use of fluoride, are recommended but the scientific evidence for their effectiveness is still limited. In cases where acid reflux disease is the cause, treatment with medicines can have the effect of reducing the progression of tooth wear. Recognising a non-active condition, for example after successful preventive treatment, is difficult, but will be supported with digital methods in the near future.


Assuntos
Odontologia Preventiva/métodos , Erosão Dentária/prevenção & controle , Desgaste dos Dentes/prevenção & controle , Adolescente , Diagnóstico Precoce , Feminino , Humanos , Masculino , Países Baixos/epidemiologia , Prevalência , Fatores de Risco , Erosão Dentária/diagnóstico , Desgaste dos Dentes/diagnóstico
2.
SEMERGEN, Soc. Esp. Med. Rural Gen. (Ed. Impr.) ; 44(2): 138-143, mar. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-174380

RESUMO

Se ha constatado en el embarazo la asociación entre problemas de salud oral y complicaciones obstétricas. Por ello, el objetivo principal de este trabajo es evaluar en embarazadas la percepción de salud oral, hábitos y creencias relativas. Se diseñó un cuestionario para obtener información de las embarazadas que acudían a la consulta de Obstetricia del Hospital Comarcal Valdeorras y Odontología de atención primaria del Centro de Salud Valle Inclán (n=96). Se encontró que la percepción propia de muchas gestantes era padecer algún problema en la cavidad oral. Además, se reflejó que las gestantes tenían hábitos relativos a salud oral adecuados; en adición, creían que su embarazo iba a traer implícitamente problemas a su boca. Las gestantes son capaces de comprender la relación entre su salud oral, su salud sistémica y la de su futuro hijo. Se detectaron una serie de hábitos y creencias en las que sería conveniente incidir para reducir problemas sanitarios


An association has been found between oral health problems and obstetric complications during pregnancy. The main aim of this study was to assess the perception by pregnant women on their oral health and related habits and beliefs. A questionnaire was designed in order to obtain information from 96 pregnant women attending the Valdeorras Local Hospital and the primary health dental practice in the Valle Inclan Health Center. It was found that many pregnant women perceived they were suffering from some kind of problem affecting their mouth. It was shown that pregnant women had adequate habits regarding oral health, but they believed that their pregnancy would implicitly cause them to have mouth problems. Pregnant women are able to understand the impact of their oral health on their general well-being and the health of their unborn child. It has been detected that a series of habits and beliefs would ideally need to be acted upon in order to reduce health problems


Assuntos
Humanos , Feminino , Gravidez , Adulto , Pessoa de Meia-Idade , Hábitos , Saúde Bucal , Atenção Primária à Saúde/métodos , Odontologia Preventiva/métodos , Profilaxia Dentária/métodos , Gengivite/epidemiologia , Avaliação em Saúde , Nível de Saúde , Periodontite/epidemiologia , Inquéritos e Questionários , Estudos Transversais/métodos , População Urbana/estatística & dados numéricos , Hemorragia Gengival/complicações
4.
Adv Dent Res ; 29(1): 9-14, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29355423

RESUMO

A system for Caries Management by Risk Assessment (CAMBRA®) has been developed in California. The purpose of this article is to summarize the science behind the methodology, the history of the development of CAMBRA, and the outcomes of clinical application. The CAMBRA caries risk assessment (CRA) tool for ages 6 y through adult has been used at the University of California, San Francisco (UCSF), for 14 y, and outcome studies involving thousands of patients have been conducted. Three outcomes assessments, each on different patient cohorts, demonstrated a clear relationship between CAMBRA-CRA risk levels of low, moderate, high, and extreme with cavitation or lesions into dentin (by radiograph) at follow-up. This validated risk prediction tool has been updated with time and is now routinely used at UCSF and in other settings worldwide as part of normal clinical practice. The CAMBRA-CRA tool for 0- to 5-y-olds has demonstrated similar predictive validity and is in routine use. The addition of chemical therapy (antibacterial plus fluoride) to the traditional restorative treatment plan, based on caries risk status, has been shown to reduce the caries increment by about 20% to 38% in high-caries-risk adult patients. The chemical therapy used for high-risk patients is a combination of daily antibacterial therapy (0.12% w/v chlorhexidine gluconate mouth rinse) and twice-daily high-concentration fluoride toothpaste (5,000 ppm F), both for home use. These outcomes assessments provide the evidence to use these CRA tools with confidence. Caries can be managed by adding chemical therapy, based on the assessed caries risk level, coupled with necessary restorative procedures. For high- and extreme-risk patients, a combination of antibacterial and fluoride therapy is necessary. The fluoride therapy must be supplemented by antibacterial therapy to reduce the bacterial challenge, modify the biofilm, and provide prevention rather than continued caries progression.


Assuntos
Suscetibilidade à Cárie Dentária , Cárie Dentária/prevenção & controle , Odontologia Preventiva/métodos , Medição de Risco/métodos , Adolescente , Adulto , Anti-Infecciosos Locais/uso terapêutico , California , Cariostáticos/uso terapêutico , Criança , Pré-Escolar , Clorexidina/uso terapêutico , Cárie Dentária/microbiologia , Feminino , Fluoretos Tópicos/uso terapêutico , Humanos , Lactente , Masculino , Antissépticos Bucais/uso terapêutico , Fatores de Risco , Cremes Dentais/uso terapêutico
6.
Minerva Stomatol ; 67(2): 37-44, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29243447

RESUMO

BACKGROUND: The aim of this work was to evaluate the effectiveness of the SSRD Department of University of Milan PREVENTION PROGRAM between subjects of different sex and ages. METHODS: Prevention Program is divided into six stages, in which specific and standardized procedures are effected on patient; then checkups are planned after three months. Ninety patients (48 females, 42 males) were included. Subjects were divided into three ages groups: 6-9, 10-12 and over 12 years old. Plaque Index, Bleeding Index, and quantitative and qualitative variations of bacterial plaque were considered. RESULTS: Remarkable results were obtained regarding both the effective reduction of bacterial oral flora and patient's compliance and learning, especially in the group of patients older than 10 years. The new values of parameters recorded at the end of the study showed that all the subjects included in the sample had an improvement of compliance in oral hygiene, in particular: 1) P.I. level 3, 10-12 age, female; 2) B.I. level 4, males over 10, female 6-9 age; 3) quantitative and qualitative variations of bacterial plaque, level 4, all groups. CONCLUSIONS: Patient instruction and motivation allow to obtain optimal results in particular in patients aged more than 10 years.


Assuntos
Fatores Etários , Higiene Bucal/educação , Cooperação do Paciente , Educação de Pacientes como Assunto/organização & administração , Odontologia Preventiva/organização & administração , Adolescente , Bactérias/isolamento & purificação , Criança , Placa Dentária/microbiologia , Placa Dentária/prevenção & controle , Índice de Placa Dentária , Feminino , Hemorragia Gengival/epidemiologia , Humanos , Masculino , Microbiota , Motivação , Boca/microbiologia , Índice Periodontal , Odontologia Preventiva/métodos , Avaliação de Programas e Projetos de Saúde
7.
J Fam Pract ; 66(11): 699-700, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29099514

RESUMO

IT IS UNCLEAR, but studies suggest that it should be based largely on individual risk. The American Academy of Pediatric Dentistry recommends a 6-month interval for preventive dental visits (strength of recommendation [SOR]: C, expert opinion), but a 24-month interval does not result in an increased incidence of dental caries in healthy children and young adults or increased incidence of gingivitis in healthy adults (SOR: B, a single randomized controlled trial [RCT]). In adults with risk factors (eg, smoking or diabetes), visits at 6-month intervals are associated with a lower incidence of tooth loss (SOR: C, a retrospective cohort study). Children with risk factors (eg, caries) may benefit from a first dental visit by age 3 years (SOR: C, a retrospective cohort study).


Assuntos
Agendamento de Consultas , Cárie Dentária/prevenção & controle , Visita a Consultório Médico/estatística & dados numéricos , Odontologia Preventiva/métodos , Adulto , Criança , Humanos
8.
Trials ; 18(1): 436, 2017 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-28931440

RESUMO

BACKGROUND: There are a large number of clinical outcome measures used to assess the effectiveness of prevention and management strategies of periodontal diseases. This heterogeneity causes difficulties when trying to synthesise data for systematic reviews or clinical guidelines, reducing their impact. Core outcome sets are an agreed, standardised list of outcomes that should be measured and reported in all trials in specific clinical areas. We aim to develop a core outcome set for effectiveness trials investigating the prevention and management of periodontal disease in primary or secondary care. METHODS: To identify existing outcomes we screened the Cochrane systematic reviews and their included studies on the prevention and management of periodontal diseases. The core outcome set will be defined by consensus of key stakeholders using an online e-Delphi process and face-to-face meeting. Key stakeholders involved in the development will include: patients, dentists, hygienists/therapists, specialists, clinical researchers and policy-makers. Stakeholders will be asked to prioritise outcomes and feedback will be provided in the next round(s). Stakeholders will have an opportunity to add outcomes found in the Cochrane review screening process at the end of the first round. If consensus is not reached after the second round we will provide feedback prior to a third round. Remaining outcomes will be discussed at a face-to-face meeting and agreement will be measured via defined consensus rules of outcome inclusion. DISCUSSION: The inclusive consensus process should provide a core outcome set that is relevant to all key stakeholders. We will actively disseminate our findings to help improve clinical trials, systematic reviews and clinical guidelines with the ultimate aim of improving the prevention and management of periodontal diseases. TRIAL REGISTRATION: COMET ( http://www.comet-initiative.org/studies/details/265?result=true ). Registered on August 2012.


Assuntos
Pesquisa Biomédica/métodos , Ensaios Clínicos como Assunto/métodos , Técnica Delfos , Determinação de Ponto Final , Doenças Periodontais/terapia , Periodontia/métodos , Odontologia Preventiva/métodos , Projetos de Pesquisa , Consenso , Humanos , Doenças Periodontais/diagnóstico , Atenção Primária à Saúde , Atenção Secundária à Saúde , Participação dos Interessados , Resultado do Tratamento
9.
Ned Tijdschr Tandheelkd ; 124(6): 303-307, 2017 Jun.
Artigo em Holandês | MEDLINE | ID: mdl-28643822

RESUMO

Many older people have a bad oral health, with (root) caries a prevalent cause. Alarming results of research projects raise the question whether sufficient preventive measures are being taken to prevent the development and progress of (root) caries in frail older people. A review of the recent literature revealed that in frail older people and physically or cognitively impaired adults, daily use of a 5,000 ppm fluoride toothpaste and quarterly application of chlorhexidine or sodium fluoride can decrease by half the risk of root caries. In the Netherlands, toothpaste containing 5,000 ppm fluoride is not (yet) on the market. At the present time, only the advice brochure 'Prevention of root caries' is available. Another measure to prevent deterioration of oral health among frail older people is paying attention to frail older people who do not visit their dentist on a regular basis due to physical limitations and care dependency. When this is the case, it is necessary to intensify professional oral healthcare with instructions to personal caregivers and professional care providers in order to fight (root) caries.


Assuntos
Cariostáticos/uso terapêutico , Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Idoso Fragilizado , Odontologia Preventiva/métodos , Cárie Radicular/prevenção & controle , Fluoreto de Sódio/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Testes de Atividade de Cárie Dentária , Feminino , Humanos , Masculino , Cremes Dentais
10.
J Am Geriatr Soc ; 65(7): 1554-1558, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28555729

RESUMO

OBJECTIVES: To examine factors associated with dental health insurance, self-rated oral health, and use of preventive dental care services in older Asian Americans. DESIGN: Cross-sectional survey. SETTING: The Asian American Quality of Life Survey was conducted with 2,614 Asian Americans living in central Texas using questionnaires available in English and six Asian languages. PARTICIPANTS: Asian American Quality of Life Survey participants aged 60 and older (N = 533; mean age = 69.4 ± 6.9). MEASUREMENTS: Participants were asked whether they had insurance that covered the cost of any dental visit, how they would rate their overall oral health status, and whether they had visited a dental clinic for a routine examination in the past 12 months. Information was also collected on sociodemographic and immigration-related variables. RESULTS: More than 61% of the sample had no dental health insurance, 45% reported that their oral health was fair or poor, and 44% had not used preventive dental care services. A series of logistic regression analyses identified factors posing a significant risk to oral health and dental care. For example, those with limited English proficiency were 3.5 times as likely to lack dental health insurance and 3.2 times as likely to rate their oral health as fair or poor. The odds of not using preventive dental care services were 6.4 times as great in those without dental health insurance. CONCLUSION: The overall findings call attention to efforts to promote oral health and dental care in older Asian Americans.


Assuntos
Americanos Asiáticos/estatística & dados numéricos , Assistência Odontológica/estatística & dados numéricos , Saúde Bucal/estatística & dados numéricos , Idoso , Estudos Transversais , Humanos , Seguro Odontológico/economia , Odontologia Preventiva/métodos , Autorrelato , Inquéritos e Questionários , Texas
11.
J Physician Assist Educ ; 28(1): 2-9, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28207581

RESUMO

PURPOSE: Despite the prevalence of oral disease, the subject of oral health historically has been absent from medical education. We have developed an interprofessional curriculum in collaboration with our school of dentistry to teach oral health in the primary care setting to physician assistant (PA) students. The goal was to create and assess the impact of a curricular model that would be adaptable to various academic settings. METHODS: A blend of classroom, clinical skills lab, observations in the dental clinic, and observed structured clinical examinations was used to teach oral health to first-year (didactic year) PA students. The objectives were created in collaboration between the medical and dental faculties and included topics on general oral health, oral cancer, geriatrics, pediatrics, and fluoride varnish. RESULTS: A total of 12 hours of instructional time was delivered to 23 students over 3 semesters from 2014 to 2015. Pretesting and posttesting demonstrated long-term knowledge retention that was 14% better than baseline at 8 months (P < .001). Student surveys demonstrated that satisfaction levels were high and that the students felt better prepared and motivated to incorporate oral health into their practice of medicine. Analyses of students' write-ups of the history and the physical examination demonstrated that the students incorporated oral health concepts. CONCLUSIONS: A significant impact on trainees can occur after a short, focused amount of instructional time in oral health. Students demonstrate enthusiasm and begin using oral health skills early on. A focused interprofessional oral health curriculum can likely be successfully integrated into various academic settings with a positive effect on learning and improved patient care.


Assuntos
Educação em Odontologia/métodos , Relações Interprofissionais , Saúde Bucal/educação , Assistentes Médicos/educação , Estudantes de Odontologia/psicologia , Atitude do Pessoal de Saúde , Currículo , Feminino , Humanos , Masculino , Higiene Bucal , Odontologia Preventiva/métodos
12.
J Dent Educ ; 80(9): 1071-81, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27587574

RESUMO

In 2005, Public Act No. 161 (PA 161) was passed in Michigan, allowing dental hygienists to practice in approved public dental prevention programs to provide services for underserved populations while utilizing a collaborative agreement with a supervising dentist. The aims of this study were to assess how well dental and dental hygiene students and faculty members and practicing dental hygienists have been educated about PA 161, what attitudes and knowledge about the act they have, and how interested they are in additional education about it. University of Michigan dental and dental hygiene students and faculty members, students in other Michigan dental hygiene programs, and dental hygienists in the state were surveyed. Respondents (response rate) were 160 dental students (50%), 63 dental hygiene students (82%), 30 dental faculty members (26%), and 12 dental hygiene faculty members (52%) at the University of Michigan; 143 dental hygiene students in other programs (20%); and 95 members of the Michigan Dental Hygienists' Association (10%). The results showed that the dental students were less educated about PA 161 than the dental hygiene students, and the dental faculty members were less informed than the dental hygiene faculty members and dental hygienists. Responding dental hygiene faculty members and dental hygienists had more positive attitudes about PA 161 than did the students and dental faculty members. Most of the dental hygiene faculty members and dental hygienists knew a person providing services in a PA 161 program. Most dental hygiene students, faculty members, and dental hygienists wanted more education about PA 161. Overall, the better educated about the program the respondents were, the more positive their attitudes, and the more interested they were in learning more.


Assuntos
Higienistas Dentários , Docentes de Odontologia , Odontologia Preventiva/métodos , Papel Profissional , Estudantes de Odontologia , Adulto , Idoso , Atitude do Pessoal de Saúde , Higienistas Dentários/educação , Higienistas Dentários/organização & administração , Higienistas Dentários/psicologia , Educação em Odontologia , Docentes de Odontologia/psicologia , Feminino , Humanos , Masculino , Michigan , Pessoa de Meia-Idade , Odontologia Preventiva/legislação & jurisprudência , Estudantes de Odontologia/psicologia , Inquéritos e Questionários , Adulto Jovem
13.
J Am Dent Assoc ; 147(9): 702-8, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27158078

RESUMO

BACKGROUND: In this study, the authors examined the prevalence and cost of care for children enrolled in Medicaid for potentially preventable dental conditions who receive surgical care in hospital operating rooms (ORs) or ambulatory surgery centers (ASCs). METHODS: The authors analyzed Medicaid data from 8 states to find cases in which children aged 1 to 20 years received surgical care in ORs or ASCs in 2010 and 2011 for potentially preventable diagnoses, as defined with diagnostic codes. RESULTS: For 6 states with complete data, there were 26,373 cases in 2011 in which children received OR or ASC surgical care for potentially preventable conditions. These cases represent approximately 0.5% of all children enrolled in Medicaid in these states and approximately 1% of children enrolled in Medicaid who received any dental care. There were $68 million in total Medicaid payments for these cases, with an average of $2,581 per case. Diagnostic codes indicated that 98% of cases were related to treatment of dental caries. More than two-thirds of the cases (71%) were children aged 1 to 5 years. CONCLUSIONS: Extrapolation to the United States suggests that approximately $450 million in additional expenditures occurred in 2011 because of OR or ASC surgical care for potentially preventable pediatric dental conditions, primarily related to early childhood caries. PRACTICAL IMPLICATIONS: Strategies to improve prevention of early childhood caries, including community- and family-based education, and to increase access to timely and early dental care for low-income children could reduce the burdens and costs of these dental problems.


Assuntos
Assistência Odontológica para Crianças/métodos , Cárie Dentária/cirurgia , Medicaid , Salas Cirúrgicas/estatística & dados numéricos , Odontologia Preventiva/métodos , Adolescente , Fatores Etários , Procedimentos Cirúrgicos Ambulatórios/estatística & dados numéricos , Criança , Pré-Escolar , Efeitos Psicossociais da Doença , Assistência Odontológica para Crianças/economia , Assistência Odontológica para Crianças/estatística & dados numéricos , Cárie Dentária/economia , Cárie Dentária/prevenção & controle , Custos de Cuidados de Saúde , Humanos , Lactente , Medicaid/economia , Estados Unidos/epidemiologia , Adulto Jovem
15.
Int J Dent Hyg ; 14(4): 284-288, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26608383

RESUMO

OBJECTIVES: The aim of this study was to determine whether a qualified dental hygienist could improve oral health outcomes for residents living in residential aged care facilities on the Central Coast of New South Wales, Australia. METHODS: A qualified dental hygienist undertook a 24-week oral hygiene intervention in five residential aged care facilities to test the Senior Smiles, oral health model of care. The facilities were invited to take part in the research, which was funded by a grant from NSW Medicare Local, Erina. Residents were asked to consent to having oral health risk assessments, oral healthcare plans and to receiving referrals for treatment where needed. Pre- and post-intervention plaque scores were recorded for residents and P values calculated using a paired t-test. In addition, the number of residents examined, treated and referred for more complex dental care was recorded. RESULTS: The statistical analysis program, SPSS, was used to conduct a paired t-test to compare pre- and post-intervention plaque scores on residents from the 5 RACFs. A statistically significant result of P < 0.0001 showed the intervention of the dental hygienist was effective in reducing plaque scores in residents across the 5 RACFs. CONCLUSION: The Senior Smiles model of care provided residents with preventive oral hygiene care, referral pathways for complex dental treatment needs and established a formal management programme for ongoing oral health care within the RACFs. The Senior Smiles model of care is successful and transportable.


Assuntos
Assistência Odontológica para Idosos/métodos , Higienistas Dentários , Instituição de Longa Permanência para Idosos , Idoso , Placa Dentária/terapia , Humanos , Modelos Organizacionais , Saúde Bucal , Odontologia Preventiva/métodos
17.
Trials ; 16: 505, 2015 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-26537725

RESUMO

BACKGROUND: In England and Scotland, dental extraction is the single highest cause of planned admission to the hospital for children under 11 years. Traditional dental services have had limited success in reducing this disease burden. Interventions based on motivational interviewing have been shown to impact positively dental health behaviours and could facilitate the prevention of re-occurrence of dental caries in this high-risk population. The objective of the study is to evaluate whether a new, dental nurse-led service, delivered using a brief negotiated interview based on motivational interviewing, is a more cost-effective service than treatment as usual, in reducing the re-occurrence of dental decay in young children with previous dental extractions. METHODS/DESIGN: This 2-year, two-arm, multicentre, randomised controlled trial will include 224 child participants, initially aged 5 to 7 years, who are scheduled to have one or more primary teeth extracted for dental caries under general anaesthesia (GA), relative analgesia (RA: inhalation sedation) or local anaesthesia (LA). The trial will be conducted in University Dental Hospitals, Secondary Care Centres or other providers of dental extraction services across the United Kingdom. The intervention will include a brief negotiated interview (based on the principles of motivational interviewing) delivered between enrollment and 6 weeks post-extraction, followed by directed prevention in primary dental care. Participants will be followed up for 2 years. The main outcome measure will be the dental caries experienced by 2 years post-enrollment at the level of dentine involvement on any tooth in either dentition, which had been caries-free at the baseline assessment. DISCUSSION: The participants are a hard-to-reach group in which secondary prevention is a challenge. Lack of engagement with dental care makes the children and their families scheduled for extraction particularly difficult to recruit to an RCT. Variations in service delivery between sites have also added to the challenges in implementing the Dental RECUR protocol during the recruitment phase. TRIAL REGISTRATION: ISRCTN24958829 (date of registration: 27 September 2013), Current protocol version: 5.0.


Assuntos
Assistência Odontológica para Crianças/métodos , Cárie Dentária/prevenção & controle , Entrevista Motivacional , Odontologia Preventiva/métodos , Atenção Primária à Saúde/métodos , Prevenção Secundária/métodos , Fatores Etários , Anestesia/métodos , Criança , Comportamento Infantil , Pré-Escolar , Protocolos Clínicos , Assistentes de Odontologia , Assistência Odontológica para Crianças/enfermagem , Cárie Dentária/diagnóstico , Cárie Dentária/psicologia , Cárie Dentária/cirurgia , Suscetibilidade à Cárie Dentária , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pais/psicologia , Educação de Pacientes como Assunto , Recidiva , Projetos de Pesquisa , Fatores de Risco , Fatores de Tempo , Extração Dentária , Resultado do Tratamento , Reino Unido
18.
PLoS One ; 10(10): e0140847, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26496187

RESUMO

BACKGROUND AND OBJECTIVE: Prospective studies that investigated the influence of surgical and nonsurgical procedures in the recurrence of periodontitis and tooth loss in periodontal maintenance therapy (PMT) programs have not been previously reported. The objective of this study was to evaluate longitudinally the recurrence of periodontitis in regular compliers (RC) and irregular compliers (IC) individuals undergoing surgical and non-surgical procedures over 5 years in a program of PMT. MATERIALS AND METHODS: A total of 212 individuals participated in this study. Full-mouth periodontal examination including bleeding on probing, probing depth, and clinical attachment level were determined at all PMT visits over 5 years. The recurrence of periodontitis was evaluated in RC and IC individuals undergoing surgical and non-surgical procedures in PMT. The influences of risk variables of interest were tested through univariate analysis and multivariate logistic regression. RESULTS: Recurrence of periodontitis was significantly lower among RC when compared to IC. Individuals with recurrence of periodontitis and undergoing surgical procedures showed higher probing depth and clinical attachment loss than those who received non-surgical procedures. Recurrence of periodontitis was higher in individual undergoing surgical procedures and irregular compliance during PMT. CONCLUSIONS: Irregular compliance and surgical procedures in individuals undergoing PMT presented higher rates of recurrence of periodontitis when compared to regular compliant patients undergoing non-surgical procedures.


Assuntos
Profilaxia Dentária/métodos , Periodontite/diagnóstico , Periodontite/prevenção & controle , Odontologia Preventiva/métodos , Adulto , Idoso , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Cooperação do Paciente , Estudos Prospectivos , Recidiva , Fatores de Tempo , Adulto Jovem
19.
BMC Oral Health ; 15 Suppl 1: S10, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26391730

RESUMO

BACKGROUND: Population health needs are changing. The levels of dental caries and periodontal disease across the population as a whole is falling. The proportion of adults with a functional dentition in many developed countries has increased substantially and edentulous rates have dropped to some of their lowest levels. Despite this, a pronounced social gradient still exists, many adults do not attend dental services regularly and disease in young children remains intransigent amongst the poorest. New challenges are emerging too as the growing number of older people, above sixty-five years of age, retain their teeth. METHODS: Ensuring "the right number of people with the right skills are in the right place at the right time to provide the right services to the right people" is critical for future dental service provision, both to meet the new challenges ahead and to ensure future services are cost-effective, efficient and reduce health-inequalities. Greater use of "skill-mix" models could have a substantial role in the future, as dentistry moves from a "cure" to a "care" culture. DISCUSSION: The provision of dental services in many countries currently adopts a "one-size-fits-all", where the dentist is the main care-giver and the emphasis is on intervention. As needs change in the future, the whole of the dental team should be utilised to deliver primary, secondary and tertiary prevention in an integrated model. Growing evidence suggests that other members of the dental team are effective in providing care, but introducing this paradigm shift is not without its challenges. The provision of incentives within funding systems and social acceptability are amongst the key determinants in producing a service that is responsive to need, improves access and delivers equity.


Assuntos
Doenças da Boca/prevenção & controle , Odontologia Preventiva/métodos , Assistência Odontológica/métodos , Assistência Odontológica/tendências , Odontólogos , Humanos , Doenças da Boca/economia , Saúde Bucal/tendências , Recursos Humanos
20.
BMC Oral Health ; 15 Suppl 1: S12, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26391906

RESUMO

BACKGROUND: This paper is a summary document of the Prevention in Practice Conference and Special Supplement of BMC Oral Health. It represents the consensus view of the presenters and captures the questions, comments and suggestions of the assembled audience. METHODS: Using the prepared manuscripts for the conference, collected materials from scribes during the conference and additional resources collated in advance of the meeting, authors agreed on the summary document. RESULTS: The Prevention in Practice conference aimed to collate information about which diseases could be prevented in practice, how diseases could be identified early enough to facilitate prevention, what evidence based therapies and treatments were available and how, given the collective evidence, could these be introduced in general dental practice within different reimbursement models. CONCLUSIONS: While examples of best practice were provided from both social care and insurance models it was clear that further work was required on both provider and payer side to ensure that evidence based prevention was both implemented properly but also reimbursed sufficiently. It is clear that savings can be made but these must not be overstated and that the use of effective skill mix would be key to realizing efficiencies. The evidence base for prevention of caries and periodontal disease has been available for many years, as have the tools and techniques to detect, diagnose and stage the diseases appropriately. Dentistry finds itself in a enviable position with respect to its ability to prevent, arrest and reverse much of the burden of disease, however, it is clear that the infrastructure within primary care must be changed, and practitioners and their teams appropriately supported to deliver this paradigm shift from a surgical to a medical model.


Assuntos
Assistência Odontológica/métodos , Doenças da Boca/prevenção & controle , Odontologia Preventiva/métodos , Assistência Odontológica/economia , Humanos , Doenças da Boca/diagnóstico , Doenças da Boca/economia , Doenças da Boca/terapia , Saúde Bucal/economia , Odontologia Preventiva/economia , Recursos Humanos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA